Should the Study Be Stopped? Ethical Implications of Global Humanitarian Research on Children

When conducting international research, especially involving the wellbeing of children, it is of paramount importance to consider not only the results of the study but the ethical considerations involved throughout the research process as well. One such study on children, the Bucharest Early Intervention Project (BEIP), was established as a “longitudinal, randomized controlled trial of foster care as an intervention for children in institutions” in Bucharest, Romania (Zeanah et al.). For some context, prior to the collapse of the Soviet Union, Romania was under the stringent dictatorship of Nicolae Ceaucescu who required that all women must produce five children to stimulate Romanian productivity by supposedly increasing the number of workers in Romania. Procedures such as abortions or forms of contraception were prohibited, and many families simply did not have the means to support that many children and handed them to government institutions. When Ceaucescu was overthrown in 1989, there were as many as 200,000 children institutionalized (Zeanah et al.). Needless to say, children suffered an inordinate amount of behavioral, psychological, and health illness from their living conditions, and so this project was dedicated to providing evidence that demonstrated that foster care provided better conditions for child development and functioning.

    Especially for audiences who might not have learned about institutionalized child care, it might be a bit hard to understand what kind of effects the child’s surrounding environment and social interaction has on their psychological and emotional development. In a study called “The Effects of Institutionalization and Parental Living Status on Children’s Self Esteem, and Externalizing and Internalizing Problems in Rwanda,” investigators Nsabimana et al. aimed to bring to the surface the psychological adjustment required by orphans in institutional care in Rwanda. They found that “children in institutions had more externalizing behavior problems than had children in families,” and lower self-esteem was also observed in institutionalized children (Nsabimana et al.). Similarly to the researchers of the BEIP, these investigators came to the conclusion that their results suggest that “an adequate foster family should be preferred before an institution” when making the decision to “place a child out of his or her family origin” (Nsabimana et al.). 

While the application of ethical frameworks were present in both of these studies, there is still a looming concern for effects of these studies on children. With an eventual aim for benefitting and improving the communities that the research is being conducted in as well as providing evidence for future improvements to child care environments all around the globe, is it ethical for such research on children to be conducted, even as a certain group of children are subjected to suboptimal living conditions while the researchers see that the treatment provided to the test group is clearly more beneficial? On one hand, as in the BEIP study, it is advantageous to have a longitudinal study that provides evidence that foster care is a more adequate living environment for young children as they develop than institutions, which can help other nations adopt policies that transition children from institution to more family-based solutions. On the other hand, while there was no interference with the children who were monitored in their living conditions in the institutions, meaning that they were allowed to be adopted or transferred to a foster home not initiated by the study, those children still suffered. Those children during their crucial developmental years still were subjected to the psychological and overall health impact that living in institutionalized care had on them. 

Given the drastic disparity between the benefits experienced by children in foster care and children in institutional care in these two studies, is it not the ethical duty of those researchers and government bodies involved to provide the best possible benefits with the resources they have to those children in inadequate living conditions? These studies emphasize the fact that as we move forward in understanding different aspects of child development, it is important for researchers to take into consideration the impact of their work, not only for future generations, but with the current participants who they are working with as well.

Sources:

1. Nsabimana, Epaphrodite, et al. "Effects of institutionalization and parental living status on children’s self-esteem, externalizing and internalizing problems in Rwanda." Frontiers in psychiatry 10 (2019): 442.

2. Zeanah, Charles H et al. “The Bucharest Early Intervention Project: case study in the ethics of mental health research.” The Journal of nervous and mental disease vol. 200,3 (2012): 243-7. doi:10.1097/NMD.0b013e318247d275